• Care Review Clinician , Prior…

    Molina Healthcare (Albuquerque, NM)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... (RN) license in good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization… more
    Molina Healthcare (07/12/25)
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  • Care Review Clinician , Prior…

    Molina Healthcare (Albuquerque, NM)
    …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
    Molina Healthcare (07/24/25)
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  • Care Review Clinician

    Molina Healthcare (Santa Fe, NM)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina care model. + Adheres to utilization management ( UM ) policies and ... or emergency room. + Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (07/18/25)
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  • Care Review Clinician

    Molina Healthcare (Las Cruces, NM)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... in Nursing **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (07/18/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Las Cruces, NM)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... and holidays.** Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician

    Molina Healthcare (Albuquerque, NM)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
    Molina Healthcare (06/27/25)
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  • Director, Physician Leadership - Medical Directors…

    Humana (Santa Fe, NM)
    …key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our 5+ million ... and partnering across the enterprise (eg, with Clinical Operations, Markets, Care Management, Analytics, Pharmacy, etc.) to develop discrete, high-value strategies… more
    Humana (07/18/25)
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